Irene Hartmann
06/20/2020 - 7:01
- Clarín.com
- Society
The World Health Organization launched an alert so that countries, especially those -like Argentina- are about to start the winter, manage their resources in such a way that neither addressing the coronavirus nor other seasonal respiratory diseases makes them collapse sanitary capacity. While Covid-19 is on everyone's lips, what is happening to the flu and other winter infections? Are they tested or did they remain in the background?
A month ago Clarín reported that these viruses (influenza, respiratory syncytial virus, adenovirus) were "on the decline", up to 25% less compared to other years. Focusing on influences (the classic flu), the smallest circulation was accurate because they were tested, as a "forced step number 1" to any suspected case of Covid-19, thing to ration the scarce (and expensive) resources of reagents that determine the presence of coronavirus.
But weeks ago (two months, approximately) that was stopped and the way to test was reversed : first, coronavirus is ruled out and if the diagnosis is negative, other pathogens are sought, confirmed sources from the Buenos Aires Ministry of Health and the province of Buenos Aires.
Vaccination campaign. Photo: Silvana Boemo
What made the pre-winter role of influenza fade? Beyond what the WHO says, "one studies what he calculates first thatit is more frequent to find. And of the respiratory ones, today the one that dominates in 90% of the pictures is the coronavirus . So the logical thing is to study that one first ”, clarified Cristina Freuler, head of Infectology of the German Hospital.
At this point, the figures of the City's epidemiological bulletins are unbeatable. Comparing this year's determinations with those of 2019 (as of June 14, in both cases), 83% of the 7,000 tests made that year had given “refusals”. Of the remaining 17%, 63% had diagnosed respiratory syncytial virus; , 19%, adenoviruses, and influences (and other similar viruses) accounted for 15%.
This year the configuration has been another. First, many more samples were analyzed: 41,000. 75% were negative and the remaining 25% were distributed in almost 97% for Covid-19 ; 1.7%, adenovirus , and only 1.1% between influenza and its "sister", parainfluenza. Others, such as respiratory syncytial virus (causal number one in the bronchiolitis tables), hardly appear in the statistics.
Due to the quarantine, the boys do not go to school and this reduces the circulation of many viruses.
Experts such as Freuler and also Arnaldo Casiró, head of Infectology at the Álvarez Hospital, agreed on several aspects that illuminate these figures. They said that this year, consultations for "the other viruses" (non-Covid) have been very few because, a) people are avoiding stepping on the health centers for "nonsense" and only do so if it is essential; b) quarantine greatly reduced the circulation of these pathogens because the great "vector" of transmissibility, the boys , is indoors. Doctors noted that it is at school that they primarily acquire pathogens that they then "pass" on to their families. And c) this year "the flu vaccination campaign was very successful", both experts said.
The same was confirmed by the Buenos Aires Ministry of Health: this year 512,450 doses were given, while in 2019 they had been just over 507,000. And, along the same lines, sources close to PAMI reportedthat the 2020 campaign, advanced, this time, two weeks, worked very well : they went from 900,000 doses in 2019 to 1,000,000 (as of June 13).
But Freuler and Casiró made a reservation: Today there is no influenza, but winter is just beginning and everything could change from one day to the next, according to the "rigidity" of the mandatory insulation. However, both remarked that, in principle, they do not see an accurate risk due to the potential co-circulation of the coronavirus and the other infectious ones . They explained that, saving some symptoms of pneumonia, hospitalization of adults for these other diseases is not so common.
Pediatric world
It is different for boys, explained Juan Carlos Morales, head of the Infectious Diseases service at the Children's Hospital of La Plata: "Complications from these other viruses are more common in the pediatric population, but since the pandemic began in March of the patients we have hospitalized, in very few circumstances we have isolated seasonal respiratory viruses. Anyway, in our institution we monitor everything, not just Covid. We do a complete virological panel on a boy with fever, cough and respiratory distress because there could be a coinfection ”.
Now those pictures are not coming, but Morales explained that this is what they saw in March: “Patients with Covid and the flu came, many of them from abroad, from areas where the seasonal circulation of influenza had already occurred. That later changed and, in fact, a paradigm shift is being generated in the presentation of infectious diseases ”.
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Watch the specialIt is all a matter of "niches", summarized the expert: "There are doctors who explain that in nature there is an ecological niche that is occupied by a certain causal agent . So, one year influenza predominates, another year adenovirus; another, respiratory syncytial virus. But this year, that space was occupied by Covid. It does not mean that the others do not circulate, but they do not dominate ”.
For Morales, as long as the mandatory isolation continues, "the trend will surely continue like this." In other words, the winter scene seems "good" within everything? The doctor qualified his words: “Quarantine helps, but many families are skipping the general health controls of their children . Isolation shouldn't generate that. A specialist should evaluate the growth and development of children. In this, fear cannot win. ”
ACE